KIDNEY transplant recipients who transferred early to a Hospital-at-Home (HaH) programme experienced shorter hospital stays and lower healthcare costs while maintaining comparable clinical outcomes to conventional inpatient care, according to findings from a propensity score matched study.
Reducing the length of hospital stay after kidney transplant remains an important goal for transplant units, provided patient outcomes are not compromised. Investigators evaluated an early HaH pathway that transferred kidney transplant recipients from hospital beginning on postoperative day 4. The study examined the first 100 patients managed under this protocol and compared them with a matched historical cohort treated between 2013–2019 before the programme was introduced.
The comparison used one to one propensity score matching with a calliper of 0.05 across 13 donor and recipient characteristics, together with the type of immunosuppression and delayed graft function. Clinical outcomes remained comparable between groups throughout one year of follow up. Rates of rejection, renal function, patient survival and graft survival showed no significant differences between patients receiving HaH care and those managed entirely in hospital.
Patients transferred to HaH had a significantly shorter median length of hospital stay than the historical cohort at 5 days compared with 9 days: (P<0.001). The median duration of HaH admission was 5 days. When both hospital admission and HaH care were combined, the overall duration of care was similar between groups at 10 days versus 9 days (p=0.117).
Readmission rates at both 30 days and 90 days were also similar, indicating that earlier discharge from hospital did not lead to an increase in short term hospital returns.
The HaH pathway was associated with lower overall costs for the transplant episode. Mean costs were €31,874±9,114 compared with €35,780±15,720 in the historical cohort (p=0.033). The reduction was primarily attributed to decreased inpatient ward use and lower in hospital medication costs.
The investigators concluded that early transfer to HaH optimised healthcare resource use while preserving clinical outcomes after kidney transplant. These findings suggested that this care model could provide a practical strategy for reducing hospital utilisation without compromising patient safety in appropriately selected kidney transplant recipients.
Reference
Cucchiari D et al. Safety and economic benefits of early hospital-at-home transfer after kidney transplantation: a propensity-score matched study from Spain. Eur J Health Econ. 2026;DOI10.1007/s10198-026-01963-y.
Featured Image: saksit on Adobe Stock
Each article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.
